Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA.
Am J Clin Nutr. 2013 Mar;97(3):480-6. doi: 10.3945/ajcn.112.047787. Epub 2013 Jan 30.
Visceral adipose tissue (VAT) has been identified as a harmful fat depot, and sex and race differences in VAT have been reported in white and African Americans.
We determined the clinical utility of VAT in the identification of individuals at elevated cardiometabolic risk in white and African American adults and compared the clinical utility with measures obtained by using dual-energy X-ray absorptiometry (DXA) and anthropometric measures.
The sample included 429 white women, 311 African American women, 406 white men, and 100 African American men who were 18-74 y of age. VAT was measured by using computed tomography, fat mass (FM) and percentage of body fat were measured by using DXA, and waist circumference (WC) and BMI were assessed. Receiver operating characteristic curves were used to compare the utility of measures in the identification of participants in the upper quintile of a continuous score derived from principal components analysis of fasting glucose, HDL cholesterol, triglycerides, and blood pressure.
The clinical utility of measures varied across sex-by-race groups. In the overall sample, the areas under the curve were significantly higher for VAT and WC in comparison with the other indicators. Identified VAT thresholds were higher in white men (140 cm(2)) and women (141 cm(2)) than in African American men (82 cm(2)) and women (97 cm(2)).
VAT and WC showed greater clinical utility than did other obesity measures. Because of the complexity of measuring VAT, the use of WC is recommended for the identification of adults with elevated cardiometabolic risk factors. The Pennington Center Longitudinal Study was registered at clinicaltrials.gov as NCT00959270.
内脏脂肪组织（VAT）已被确定为有害的脂肪储存库，并且已经在白种人和非裔美国人中报道了 VAT 的性别和种族差异。
我们确定了 VAT 在识别白种人和非裔美国成年人中代谢风险升高的个体中的临床应用，并将其与通过双能 X 射线吸收法（DXA）和人体测量学测量获得的指标进行了比较。
该样本包括 429 名白人女性、311 名非裔美国女性、406 名白人男性和 100 名非裔美国男性，年龄在 18-74 岁之间。通过计算机断层扫描测量 VAT，通过 DXA 测量脂肪量（FM）和体脂肪百分比，通过腰围（WC）和 BMI 进行评估。使用接受者操作特征曲线比较了各种指标在识别主要成分分析空腹血糖、高密度脂蛋白胆固醇、甘油三酯和血压连续得分的前五个五分位数参与者中的应用。
这些指标在不同性别和种族组之间的临床应用有所不同。在整个样本中，VAT 和 WC 的曲线下面积明显高于其他指标。在白人男性（140cm²）和女性（141cm²）中，确定的 VAT 阈值高于非裔美国男性（82cm²）和女性（97cm²）。
VAT 和 WC 比其他肥胖指标具有更大的临床应用价值。由于 VAT 的测量较为复杂，建议使用 WC 来识别代谢风险因素升高的成年人。彭宁顿中心纵向研究在 clinicaltrials.gov 上注册为 NCT00959270。
